Hand surgery table

ABSTRACT

A hand surgery table having a platform (3) and a universal-type joint (6) connecting that platform (3) to a base (5) whereby the disposition of the platform (3) relative to the base (5) can be varied to suit requirements. A lock member (13) is provided to releasably secure the platform (3) in a selected disposition. The platform (3) is releasably connectable to the support structure (2) of the table so that it can be separated for cleaning or disposal, and a frangible detent (26) may be provided to show that the platform (3) has been previously used. A plurality of column supports (41) are attachable to the platform (3) at any of a plurality of positions across the upper surface of the platform (3) and at least some of those supports (41) have a contoured upper end. The column supports (41) cooperate with holes (31) in the platform (3) which also serve as drainage holes.

This invention relates to a table on which a person's hand can besupported for the purpose of enabling a surgical operation to be carriedout on that hand.

Hand surgery tables generally fall into two classes-those which are verysimple in construction and those which are complex. The former type donot adequately serve the needs of surgeons because of their inability tosupport the hand in any of a variety of postures. Examples of that typeare disclosed by U.S. Pat. Nos. 3,746,332 and 4,082,257. The latter typeare expensive and in spite of their complexity may not provide anadequate variety of hand support positions. Another problem with some ofthe latter type is that they are difficult to use.

British Pat. No. 2088216 discloses one form of rather complex handsurgery table which has a series of elongate supports which can berendered rigid or flexible as required and each of which engages arespective finger of the hand to be operated upon. The construction isexpensive and is also difficult to use because of the need to separatelyadjust each of the flexible finger supports.

It is an object of the present invention to provide a hand surgery tableof relatively simple construction which enables a hand to beconveniently supported in any one of a variety of dispositions andpostures. It is a further object of the invention in a preferred form toprovide such a table having a disposable platform.

A hand surgery table according to the invention is characterized in thatit includes a primary support platform which can be secured in a varietyof positions to achieve a general disposition for a hand placed overthat platform, and at least one column support which can be selectivelyattached to the platform to hold part of the hand in a particularposture relative to the platform. Preferably, there is a plurality ofcolumn supports and they may be of various sizes and forms so as torender the table readily adaptable to a variety of situations. In apreferred form, the platform is disposable so that adequate standards ofhygiene can be achieved without the need to carefully clean the platformafter each use.

According to the present invention there is provided a hand surgerytable including, a platform, mounting means for said platform and whichis adjustable to permit variation of the disposition of said platformrelative to a support, locking means operable to releasably hold saidmounting means in a selected position of adjustment, at least one columnsupport releasably attachable to said platform at any one of a pluralityof stations provided across said platform, and locating means providedat each said station and each being cooperable with a part of a saidcolumn support so as to hold that column support in an operativedisposition at which it projects upwardly from an upper surface of saidplatform.

Although the preceding and subsequent passages of the specificationidentify the table as a hand surgery table, :t is to be understood thatit may also have uses in other fields of surgery. For example, the tablemay be used for foot surgery or for urological surgery. The claims atthe end of the specification are to be read accordingly.

The essential features of the invention, and further optional features,are described :n detail in the following passages of the specificationwhich refer to the accompanying drawings. The drawings, however, aremerely illustrative of how the invention might be put into effect, sothat the specific form and arrangement of the features (whether they beessential or optional features) shown is not to be understood aslimiting on the invention.

In the drawings:

FIG. 1 is a perspective view of one form of table in accordance with theinvention and showing the platform separated from mounting structure;

FIG. 2 is a view similar to FIG. 1 but showing the platform connected tothe mounting structure;

FIG. 3 is an exploded perspective view of the mounting structure of thetable shown in FIGS. 1 and 2;

FIG. 4 is a cross-sectional view taken along line IV--IV of FIG. 1 andshowing the locking means in the operative condition;

FIG. 5 is a view similar to FIG. 4 but showing the locking means in arelease condition;

FIG. 6 is a top plan view of part only of the platform shown in FIGS. 1and 2;

FIG. 7 is cross-sectional view taken along line VII--VII of FIG. 6;

FIG. 7 is a cross-sectional view taken along line VIII--VIII of FIG. 6;

FIG. 9 is a plan view of a typical platform for use with the table ofFIGS. 1 and 2;

FIG. 10 is a side elevational view of a table as shown in FIGS. 1 and 2when used in a particular fashion;

FIG. 11 is an underneath plan view of a perimeter portion of theplatform shown in FIG. 9;

FIG. 12 is a cross-sectional view taken along line XII--XII of FIG. 11;

FIG. 13 is a perspective view of part only of the perimeter of shown inFIG. 9;

FIG. 14 shows a typical set of column supports for use with the table 1and 2;

FIG. 15 is an isometric view showing the platform of FIG. 9 and some ofthe column supports of FIG. 14 as arranged for cooperative engagement;

FIG. 16 is a view similar to FIG. 7 but on an enlarged scale showingdetails of the engagement between the platform and the base; and

FIG. 17 is a sectional view similar to FIG. 16 but showing the frangiblecomponent snapped into place after engagement of the platform with thebase.

A table 1 according to the invention and as shown in the attacheddrawings includes an adjustable mounting 2 for the platform 3 so thatthe disposition of the platform 3 can be varied to suit circumstances.That mounting 2 may be supported on the upper end of a member 4upstanding from an appropriate base 5, and any suitable means may beadopted for the purpose of the aforementioned adjustment. The member 4may be long or short according to requirements. According to thearrangement shown, the mounting 2 is connected to the member 4 through aball joint 6 although any other connection allowing substantiallyuniversal relative movement may be used.

The particular mounting 2 as shown includes a substantially flatmounting plate 7 arranged to receive the platform 3 as hereinafterdescribed and having a pair of laterally spaced side walls 8 and 9depending from a lower surface thereof. One side wall 8 may be fixed toor formed integral with the mounting plate 7, whereas the other wall 9is arranged for relative movement as hereinafter described. In theexample form shown, a spherical enlargement 10 is provided at the upperend of the member 4 and that enlargement 10 is located between the twoside walls 8 and 9 of the mounting 2. Preferably, each side wall 8 and 9has a part-spherical recess 11 in a surface thereof and which receives arespective side part of the spherical enlargement 10 so as to resistseparation of the mounting 2 from the member 4, but nevertheless allowpivotal movement of the mounting 2 relative to that member 4. Thepivotal movement can be in any direction subject only to limits imposedby fouling between the mounting 2 and the member 4. In the particulararrangement shown, the recess 11 of the wall 8 is formed in a separatelyformed plate-like component 12 of that wall (see FIG. 3).

Locking means 13 is provided for releasably securing the mounting 2 in aselected disposition relative to the member 4. One such means is shownin the drawings and includes a toggle lever 14 which bears against theoutside surface of the movable side wall 9 and which can be movedbetween an operative position (FIG. 4) and an inoperative position (FIG.5). In the operative position, the toggle lever 14 presses the movableside wall 9 against the spherical enlargement 10 so that the mounting 2is secured against movement by frictional engagement between thatenlargement 10 and the side walls 8 and 9. In the inoperative position,the pressure against the movable side wall 9 is reduced or removed sothat the mounting 2 can be moved relative to the member 4. Obviously,other forms of locking means could be adopted to perform the samefunction. Any suitable means may be employed to retain the movable sidewall 9 against complete separation from the remainder of the mounting 2,but in the arrangement shown screws 15 and 16 are used for that purpose.As best shown in FIG. 3, the lever 14 is pivotally connected to thescrew 16 through a pin 17.

The platform 3 is adapted to be located over the upper surface 18 (seeFIGS. 1 and 3) of the mounting plate 7 and may be secured to themounting 2 in any suitable fashion. It is preferred, however, that theplatform 3 is releasably held on the mounting 2 by conveniently operableretaining means. It is also preferred that the upper surface 18 of themounting plate 7 is substantially flat and provides a bearing surfacefor engagement with a cooperable flat part 19 (FIG. 1) of theundersurface of the platform 3. That cooperable flat part 19 may belocated substantially in the centre of the platform 3, or at any othersuitable location.

According to the arrangement shown, the retaining means includes akeying member 20 which projects from the undersurface of the platform 3,and a cooperable opening 21 in the mounting plate 7 which receives thatmember 20. In the example shown, the keying member may include arelatively short post 22 which projects substantially at right anglesoutwardly from the flat part 19 of the platform undersurface, and a bar23 connected to or formed integral with the outer end of the post 22 andextending transverse relative to the post 22. The bar 23 preferablyprojects beyond each of two opposite sides of the post 22 as shown,although it may project beyond one side only if desired. An opening 21which is substantially complementary in shape to the peripheral shape ofthe bar 23 is provided through the mounting plate 7 at a suitablelocation, and the length of the post 22 is related to the thickness ofthe portion of the plate 7 through which that opening 21 is formed.

The arrangement described above is such that the bar 23 of the keyingmember 20 can be passed neatly through the mounting plate opening 21when the platform 3 has a particular position relative to the mountingplate 7. When the opposed surfaces 19 and 18 of the platform 3 andmounting plate 7 engage, the keying member bar 23 is located so that theplatform 3 can be turned relative to the mounting plate 7 about the axisof the keying member post 22. In that way, the keying member bar 23 isdisposed so as to engage the undersurface of the mounting plate 7 andthereby prevent separation of the platform 3 from the mounting plate 7.

As shown in FIG. 6, it is preferred that the keying member bar 23 is ofdifferent size and/or shape on each side of the post 22. If the plateopening 21 is of complementary size and/or shape, the platform 3 willnot be connectable with the mounting 2 unless it has a particularposition relative to the mounting 2. One advantage of such anarrangement is that frangible detent means as hereinafter discussed canbe used.

It is further preferred, as shown by FIG. 7, that the upper surface ofeach part of the bar 23 has a sloping or camming portion 24. Thatportion 24 serves to facilitate movement of the plate 7 into the spacebetween the bar 23 and the main body of the platform 3, while enablingrelatively firm engagement between the plate 7 and platform 3 when thosecomponents are properly connected as shown in FIG. 2.

If desired, detent means may be provided to resist movement of theplatform 3 out of the operative position as shown in FIG. 2. One suchdetent means as shown in FIGS. 7 and 8 of the drawings includes a pairof recesses 25 in the upper surface of the mounting plate 7 and a pairof projections 26 on the opposed surface of the platform 3 which snapengage with those recesses 25 and which can be forced out of therecesses 25 by applying sufficient torque to the platform 3. Preferably,as indicated above, the keying member bar 23 bears against the mountingplate undersurface to provide some frictional resistance to relativeturning movement of the platform 3 and to also hold the platform 3firmly against the upper surface 18 of the mounting plate 7.

In the particular arrangement shown in FIGS. 6 to 8, each detentprojection 26 forms part of a frangible component which serves toindicate whether the platform has been previously used. According to thearrangement shown, each projection 26 is provided at an end of an arm 27which is connected at its opposite end to the platform 3 through aweakened zone 28. Actually, each arms 27 is formed integral with theplatform 3 and clearance 29 is provided on each side of the arm 27 sothat it can move laterally relative to the body of the platform 3. Thesurface 30 (FIG. 8) of each projection 26 is so shaped (e.g., inclinedas shown) that the arm 27 can be cammed outwards away from the upperplate surface 18 when the platform is being moved towards its operativeposition at which the respective projections 26 snap into one of theplate recesses 25 because of the resiliency of the arms 27. When theplatform 3 is rotated back from that operative position, 25 however, theshape of the surfaces 30 (e.g. its direction of slope) is such that theprojections 26 do not readily cam out of their recesses 25 so that thearms 27 are strained and at least one arm 27 will fracture at the zone28. Such a visible sign of prior use of the platform 3 can be useful insituations where reuse is to be avoided for purposes of hygiene.

It will be appreciated that in the arrangement described, there needonly be one projection 26 and cooperable recess 25. It will also beapparent that the retaining means as described can be modified in manyways. For example, the keying member 20 may be provided on the mountingplate 7 rather than the platform 3. Also, engagement of the retainingmeans may be effected by relative linear movement of the platform 3rather than rotational movement as described. Other variations areobviously available.

The platform 3 may be made from any suitable material, but in apreferred arrangement it is moulded or otherwise formed from a plasticsmaterial. Any appropriate peripheral shape may be adopted for theplatform 3, but it is usually convenient to have the platform 3 ofgenerally rectangular shape, with perhaps a progressive reduction inwidth at each of the two opposite end portions as shown in FIG. 9. Aplurality of holes 31 are formed at least through a major part of theplatform 3 to provide locating means for the aforementioned columnsupports. In an alternative arrangement, recesses could be provided inthe platform 3 to act as locators for the column supports, butthrough-holes are preferred as those holes can also function as drainageholes for liquid and other material. The holes 31 are preferably ofcircular cross-section, but other cross-sectional shapes could beadopted.

It is preferred that locator holes 31 are not provided through thecentral region 19 of the platform 3 which overlies the mounting plate 7.One end portion 32 of the platform 3 may also be imperforate and thatend portion 32 is preferably contoured to provide a comfortable restingsurface for the wrist area of a person's arm.

Any suitable means may be employed to hold a hand against the uppersurface of the platform. It is usually convenient, however, to useflexible straps 33 for that purpose (FIG. 10). Each such strap 33 may bein the form of an elongate band and the platform may be provided withmeans for cooperating with such straps 33. In the example shown, suchcooperating means comprises a plurality of discrete projections 34 onthe undersurface of the platform 3 and at least some of which arelocated adjacent the periphery of the platform 3. Each strap 33 has aplurality of holes 35 provided at spaced intervals along its length, andeach hole 35 is adapted to neatly receive a projection 34 so as tosecure the strap 33 in a selected position. Opposite end portions of thestrap 33 can therefore be secured to respective side portions of theplatform 3.

Further holding means may be provided in the form of an elongate sectionof elastic material such as at least one length of silicone tubing 36(FIG. 10). Such a length of tubing 36 can be secured to the platform ina selected position by means of perimeter camming recesses 37 as shownin FIGS. 11 and 12. Each such recess 37 has two oppositely facing ribs38 arranged therein so as to provide two narrow slots 39 on respectiveopposite sides of the recess 37. Those slots 39 have a width less thanthe undistorted diameter of the tubing 36 so that the tubing 36 isflattened when forced into such a slot 39 as shown in FIG. 11. Accessslots 40 provided around the periphery of the platform 3 facilitate useof the camming recesses 37 as shown by FIG. 13.

A length of tubing 36 can also function as a retractor by attaching asuitable hook (not shown) for example, to an end of the tubing 36. Thatis, the hook is engaged with the skin or flesh of a person's handlocated over the table while a remote portion of the tubing is securedby one of the camming recesses 37.

Column supports 41 are arranged so as to be positionable on the platform3 as required and each such column support 41 can be formed so as toperform a particular function. That is, there may be several columnsupports 41 of various length and the upper end 42 of at least some ofthe supports can be contoured to provide a finger resting channel 43, orotherwise arranged as required. A typical set of column supports 41 isshown in FIG. 14. Column supports 41 which are intended to support afinger may be grooved at the upper end 42 as shown to provide a concavechannel 43 or recess within which a finger can be located. The openmouth of the channel 43 could face directly upwards as shown or to oneside according to requirements.

Other column supports 41 may be adopted to engage against another partof the hand and can be shaped accordingly.

One type of column support 41, which is identified by reference numeral44 in FIG. 14, can be used as either a lateral support or an extensionpiece for another support 41. That is, one or more of the supports 44can be located on the platform 3 so as to hold a hand against lateralshifting. Alternatively, such a support 44 can have a contoured support41 attached to its upper end 45, and an attaching hole 46 is providedfor that purpose.

Each column support 41 may have a peg 47 projecting from its lower endfor location within any one of the holes 31 in the platform 3. When acolumn support 41 is so located on the platform 3, it can be rotatedabout its longitudinal axis and that enables optimum arrangement of thechannel 43 in the upper end 42, assuming the column support 41 has sucha channel 43. It is possible to provide a large number of locating holes31 through the platform 3 and thereby enable a large selection ofpositions or stations for each column support 41 (see FIG. 15). As aresult, column supports 41 of various lengths and forms can be arrangedas required over the platform 3 so as to achieve a particular posturefor a hand to be held over that platform 3.

The ability to arrange column supports 41 of selected form as requiredover the platform 3 in effect provides a platform 3 of almost infinitelyvariable contour which gives firm support to a hand. In addition, theelevation of a part or parts of a hand above the body of the platform 3facilitates access to the hand for surgery purposes.

Column supports 41 as described can be moulded or otherwise formed froma plastics material and because of their relatively low cost could bedisposable if that was thought desirable to ensure high standards ofcleanliness. The platform 3 may also be disposable for the same reason,especially as the relatively complex shape of that component makes itdifficult to clean between uses.

It will be apparent from the foregoing description that a tableaccording to the invention provides an effective and easy to operatesupport for a hand. The construction is exceedingly simple and yetenables adoption of both a general disposition and a particular posturefor a hand to be operated upon.

Various alterations, modifications and/or additions may be introducedinto the constructions and arrangements of parts previously describedwithout departing from the spirit or ambit of the invention as definedby the appended claims.

I claim:
 1. A hand surgery table including, a base, a platform having anupper surface, mounting means connecting the platform to the base andbeing adjustable to permit movement of said platform relative to thebase so that the inclination of said upper surface relative tohorizontal plane can be varied, locking means operable to releasablyhold said mounting means in a selected position of adjustment, aplurality of stations provided across said platform, locating means ateach said station, and means for supporting fingers of a patientincluding a plurality of column supports at least one column supportbeing releasably attachable to said platform at any one of saidstations, said column support having a locating part at a lower endthereof and a supporting part at an upper end thereof, said locatingpart being cooperable with said locating means of a selected saidstation so as to hold said at lost one column support in an operativeposition at which it projects outwardly from said upper surface, andsaid supporting part is thereby positioned outwardly from said uppersurface wherein an upper end of said at least one column support iscontoured to provide a finger resting surface, and said finger restingsurface forms said supporting part of said at least one column supportto thereby support that hand portion at a position relative to saidupper surface.
 2. A table according to claim 1, wherein each saidlocating means is a hole formed in said upper surface and said locatingpart is a peg projecting from the lower end of said at least one columnsupport and which is locatable in a said hole.
 3. A table according toclaim 2, wherein said peg is substantially cylindrical and is adaptedfor rotatable location in a said hole so that said at least one columnsupport can be turned about a longitudinal axis relative to saidplatform.
 4. A table according to claim 2, wherein at least some of saidholes extend completely through said platform so as to also serve asdrainage holes.
 5. A table according to claim 1, wherein at least onesaid column support functions as an extension member for connectionbetween said platform and said contoured column support.
 6. A tableaccording to claim 1, including retaining means which releasablyconnects said platform to said mounting means to enable removal of saidplatform for cleaning or disposal.
 7. A table according to claim 6,wherein said retaining means includes a keying member on said platformand a cooperable opening in said mounting means, said keying member iscooperable with said mounting means so as to permit rotation of theplatform relative to the mounting means about an axis extendingtransverse to the upper surface of the platform, and is operable toallow said platform to be removed from the mounting means when theplatform is in a particular position of rotation relative to themounting means and to prevent separation of said platform and mountingmeans when said platform is rotated away from that particular position.8. A table according to claim 7, including detent means on said platformwhich is cooperable with said mounting means to resist rotation of saidplatform relative to the mounting means from an operative positiontowards said particular position.
 9. A table according to claim 8,wherein said detent means includes a frangible component which at leastpartly separates from said platform when the platform is rotated fromsaid operative position towards said particular position.
 10. A tableaccording to claim 1, wherein said mounting means includes a ball jointconnecting the platform to the base.
 11. A table according to claim 10,wherein said locking means includes a releasable clamp which is operableto secure said ball joint against movement.
 12. A table according toclaim 1, including releasable holding means for securing part of aperson's body against movement relative to said platform.
 13. A tableaccording to claim 12, wherein said holding means includes at least oneelongate strap having a plurality of apertures therethrough, saidplatform has a plurality of pins projecting below an undersurfacethereof, and each said pin is receivable in a said strap hole so as tohold said strap in a selected position.
 14. A table according to claim12, wherein said holding means includes a plurality of recesses providedin the undersurface of said platform at locations around the peripheryof the platform, a plurality of access slots in said periphery, and atleast one elongate flexible tying member which can have a portionthereof wedged in a selected said recess and which can extend from thatrecess through an adjacent said access slot and across the upper surfaceof the platform.